OVERVIEW ABSTRACT Dr. George Koob, the Director of the National Institute on Alcohol Abuse and Alcoholism, recently called for programs that identify and promote effective preventive interventions tailored to Native people. The Native Center for Alcohol Research and Education (NCARE) at Washington State University, with our partners at the University of Colorado Denver and the University of Washington, offers coordinated efforts to mitigate and ultimately eliminate the alcohol-related devastation experienced by American Indian and Alaska Native (AI/AN) peoples through theory-based application of strategic and sustainable interventions. Achieving this goal will reduce the profound alcohol-related health disparities experienced by this underserved population. Our research agenda articulates a practical model of Native health that is grounded in theory and the daily lives of Native people. Our Research Projects and Pilot Projects will reach Native infants, youth, and adults in urban, rural, and frontier communities. Although our perspective is broad, our pragmatic grounding in the social, economic, and healthcare systems experienced by Native communities will be understandable and relevant to many audiences, including tribal communities, researchers, and clinicians. This grounding also increases the likelihood that our findings will translate into public health benefits. Our efforts will foreground prevention and intervention while contributing empirical evidence to the national conversation on healthcare costs. Collectively, this work has the potential to improve the quality of life for AI/AN with alcohol use disorders, as well as for their families and communities. NCARE proposes these activities: 1) Research Project 1: Compare the effectiveness a culturally adapted intervention against usual care for reducing risky drinking and increasing contraception use to prevent alcohol-exposed pregnancy and fetal alcohol spectrum disorders among Cheyenne River Sioux women in South Dakota; 2) Research Project 2: Compare the effectiveness of a talking circle intervention against usual care for reducing harmful behaviors and improving quality of life and healthcare use in urban Native clinic patients with alcohol problems in Seattle, Washington; and 3) Research Project 3: Test the effectiveness of motivational interviewing plus patient navigation for increasing enrollment in alcohol treatment programs and preventing re- admission to detoxification treatment for patients discharged from the Fairbanks Native Association detoxification unit in Fairbanks, Alaska. For all 3 Projects, we will conduct an economic evaluation of the interventions. These 3 Research Projects will be supported by the Administrative, Information Dissemination, Research Methods, and Pilot Project Cores. Notably, our research team includes 11 Native professionals participating in diverse roles, including Co-Leaders on all Cores and Research Projects. This unique connection between our investigators and our study population imbues our work with a special dynamic, supporting efforts to move Native alcohol research beyond a current, largely descriptive state into meaningful action.